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Professional paper - Review paper
Autoimuni pankreatitis
Medicina Fluminensis : Medicina Fluminensis, 49 (2013), 4; 364-373. urn:nbn:hr:184:183968
Krznarić Zrnić, Irena; Štimac, Davor; Milić, Sandra

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Krznarić Zrnić, I., Štimac, D. & Milić, S. (2013). Autoimuni pankreatitis. Medicina Fluminensis : Medicina Fluminensis, 49. (4), 364-373. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:183968

Krznarić Zrnić, Irena, et al. "Autoimuni pankreatitis." Medicina Fluminensis : Medicina Fluminensis, vol. 49, no. 4, 2013, pp. 364-373. https://urn.nsk.hr/urn:nbn:hr:184:183968

Krznarić Zrnić, Irena, Davor Štimac and Sandra Milić. "Autoimuni pankreatitis." Medicina Fluminensis : Medicina Fluminensis 49, no. 4 (2013): 364-373. https://urn.nsk.hr/urn:nbn:hr:184:183968

Krznarić Zrnić, I., Štimac, D. and Milić, S. (2013) 'Autoimuni pankreatitis', Medicina Fluminensis : Medicina Fluminensis, 49(4), pp. 364-373. Available at: https://urn.nsk.hr/urn:nbn:hr:184:183968 (Accessed 27 November 2024)

Krznarić Zrnić I, Štimac D, Milić S. Autoimuni pankreatitis. Medicina Fluminensis : Medicina Fluminensis [Internet]. 2013 December 02 [cited 2024 November 27];49(4):364-373. Available at: https://urn.nsk.hr/urn:nbn:hr:184:183968

I. Krznarić Zrnić, D. Štimac and S. Milić, "Autoimuni pankreatitis", Medicina Fluminensis : Medicina Fluminensis, vol. 49, no. 4, pp. 364-373, December 2013. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:183968. [Accessed: 27 November 2024]

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Metadata
Title (croatian)Autoimuni pankreatitis
Title (english)Autoimmune pancreatitis
AuthorIrena Krznarić Zrnić
AuthorDavor Štimac
AuthorSandra Milić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Internal Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract (croatian)
Autoimuni pankreatitis (AIP) prepoznat je kao zaseban klinički entitet u sklopu kroničnog upalnog procesa gušterače čija je podloga autoimuna bolest. Histološki i klinički razlikuju se dva tipa AIP-a: tip 1 – limfoplazmocitni sklerozirajući pankreatitis sa zahvaćenošću drugih organa i infiltracijom IgG4 pozitivnim stanicama te tip 2 – fibroza glavnog gušteračnog kanala s infiltracijom epitela granulocitima. Ovaj oblik pogađa mlađe ljude, a drugi organski sustavi obično nisu zahvaćeni. Najčešći simptom bolesti je opstruktivni ikterus, dok se oštri bolovi u trbuhu vrlo rijetko javljaju. Približno polovica bolesnika pokazuje neki oblik endokrine i/ili egzokrine disfunkcije gušterače. Iako je antinuklearno antitijelo (ANA) pozitivno u oko 40 % bolesnika, najosjetljivijim i najspecifičnijim markerom danas se još uvijek smatra IgG4. Dijagnoza se postavlja na osnovi dvaju kriterija: tzv. HISORt kriterija koji potječu s Mayo klinike ili Azijskih dijagnostičkih kriterija. Diferencijalno-dijagnostički najvažnije je isključiti karcinom gušterače, endosonografski vođenom biopsijom. Iako se odličan klinički odgovor postiže primjenom kortikosteroida, što je i dijagnostički vrlo značajno, budući da postoji mnogo sličnosti u kliničkoj prezentaciji bolesnika s karcinomom gušterače i AIP-a, još uvijek ne postoji standardizirani terapijski protokol njihove primjene. Danas se ovaj oblik kronične upale gušterače smatra vrlo rijetkom bolesti, no novijim spoznajama vjerojatno će se u budućnosti češće postaviti dijagnoza autoimunog pankreatitisa u bolesnika s akutnim rekuretnim bolovima u trbuhu nejasne etiologije.
Abstract (english)
Autoimmune pancreatitis (AIP) is recognised as a distinct clinical entity, identified as a chronic inflammatory process of the pancreas in which the autoimmune mechanism is involved. Histologycally and clinically we can differ two subsets: type 1 – lymphoplasmacytic sclerosing pancreatitis with other organ involvement and IgG4 positive cells infiltration and type 2- duct centric fibrosis, characterised by granulocyte epithelial lesions without systemic involvement, mostly in younger people. The major symptom at onset is obstructive jaundice, while severe abdominal pain is rare. About half patients with AIP have shown endocrine and exocrine disfunctions. The positive rate of antinuclear antibody is about 40 %, but the most sensitive and specific serologycal marker today is still IgG4. In the diagnosis of AIP two diagnostic criterions are used: the HISORt criteria (Mayo Clinic) and Asian diagnostic criteria. In differential diagnosis it is most importanat to exclude pancreatic cancer by endosonographically guided biopsy. Although high steroid responsiveness has a significant impact on the diagnosis of AIP, since patients with pancreatic cancer and AIP share many clinical features, there’s still no standardised steroid regimen. Even though the frequency of this disease seems to be quite low, by increasing knowledge on this subject in the future it will be possible to diagnose ever – increasing number of patients having acute recurrence of pain from autoimmune pancreatitis.
Keywords (croatian)
Keywords (english)
Languagecroatian
Publication typeProfessional paper - Review paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numberingvol. 49, no. 4, pp. 364-373
p-ISSN0025-7729
URN:NBNurn:nbn:hr:184:183968
Publication2013-12-02
Document URLhttp://hrcak.srce.hr/112516
Type of resourceText
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2017-05-12 10:26:59